Medicare Open Enrollment Scammer, or the Real Deal?

By Crystal Baldwin

It happened last year, and again this year. During Medicare Open Enrollment season, a concerned elder in my life called to ask if the person soliciting them was a scammer or an actual enrollment representative. The truth is, aside from highlighting some key identifiers of scams, it can be hard to tell. The scammers are so good at acting as if they are Medicare enrollment professionals, that it is enormously difficult to differentiate them from the real deal. The scams even spoof Medicare’s phone number, making the caller ID appear to be Medicare when it is not.

Medicare Open Enrollment Scam Alert

The primary difference between a telemarketer and a scammer is whether the caller is honoring the Federal Do Not Call Registry (DNC). If you ever put you number on the DNC by calling 1-888-382-1222 or by going online at donotcall.gov, you should not be receiving calls from solicitors—Even during Medicare open enrollment. You likely should not be receiving robocalls of this nature either.

What provider can call you when you are on the DNC?

Businesses with whom you have a customer relationship within the past six months, such as your Medicare provider, and other you have requested to call you. Yes, that’s it. No other unrequested calls are allowed.

More on Robocalls:

The same goes for those annoying automated/computer/robot calls. Except with these, unless you expressly opted into receiving robocalls in writing, you should not be receiving these calls either.

What if the call IS my Medicare provider, or I am interested in changing plans during open enrollment?

This is where it gets tricky. It is difficult to know whether your provider is calling instead of a scammer, especially because scammers copycat caller ID numbers. The only way to be sure is to take steps to verify by hanging up on the caller and calling back a number you know to be valid.

If you are looking to change enrollment during the Medicare open enrollment period, do so on your terms.

If you are concerned about your Medicare plan or need to report known Medicare provider fraud/abuse, contact Medicare directly at 1-800-MEDICARE (1-800-633-4227).

Please help the Consumer Assistance Program (CAP) stop Medicare scams by sharing this information with someone you know. If you have questions about this scam, or have provided personal information to the scammers, please contact CAP at 1-800-649-2424 or go online to ago.vermont.gov/cap.


Resources:

Federal Trade Commission Do Not Call Registry
Medicare

Navigating Health Care Can Be Tough: CAP Has You Covered!

Have you ever felt stressed out by the health care system? You’re not alone. Figuring out your health care options can be confusing. Here’s the good news—there are FREE programs available to help!

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Here’s a list of common questions CAP gets about health care and the FREE resources available to Vermonters:

Overcharged by your doctor’s office?

  • File a complaint with our office. CAP provides a complaint mediation service, we can you help fix billing problems. To get help, call our office at 1-800-649-2424 (toll-free in Vermont) or submit a complaint on our website.

Not sure why you can’t get Medicaid?

  • Vermont Legal Aid has a Health Care Advocate Office. They have a helpline that all Vermonters can use. They can help you learn about coverage options offered on Vermont Health Connect. They can help you figure out what care plans cover. To get help, call the HelpLine at 1-800-917-7787 or fill out their online help request form.

Confused about Medicare?

  • Contact the Agency on Aging. Their State Health Insurance Assistance Program can help you with Medicare, Choices for Care, and Social Security. Call their HelpLine at 1-800-642-5119 or call your local Agency on Aging.

Need help paying a dental bill?

  • Vermont 2-1-1 can help you find local resources to help. 2-1-1 is a program of United Ways of Vermont. They provide information and referrals 24 hours a day, 7 days a week. You can also call about emergency food and shelter, counseling, and child care. To get help, dial 2-1-1 (or 802-652-4636 – from outside of Vermont) or visit their website.

Have an insurance complaint?

  • Contact the Vermont Department of Financial Regulation’s Insurance Division. The Insurance Division regulates insurance in Vermont. To get help with filing a complaint, call 1-800-964-1784 or file a complaint online.

Still not sure who can help? Call CAP at 1-800-649-2424. Our team of consumer advisors are dedicated to helping Vermonters get the support they need. If CAP can’t help you, we’ll figure out who can.

Contributing Writer:  Lauren Jandl
Content Editor: Crystal Baldwin
Photo Credit:  Annalee Beaulieu